netFormulary

North East and North Cumbria
ICS Formulary

11 Eye

Preservative Free Eye Drops
Microbial contamination of multidose bottles of eye drops can cause eye infections that may lead to damage of the eye and in extreme cases loss of sight. To minimise the risk, multidose bottles of eye drops contain an antimicrobial preservative such as benzalkonium chloride. The preservatives used in eye drops are normally well tolerated, but they are not completely harmless. They can cause irritation and damage to the corneal epithelium. This risk is understood to be greater in patients with pre-existing damage to the ocular surface and where large quantities of preservative containing eye drops are applied repeatedly over a prolonged period (e.g. if applied more than 4 to 6 times daily for several weeks/ months).
To avoid these problems the use of preservative-free eye drops is recommended in:
 Patients who have experienced hypersensitivity reactions or irritation due to preservatives in eye drops.
 Patients who have received corneal grafts.
 Patients with conditions where there is already damage to the ocular surface as a result of disease or trauma, such as dry eye, blepharitis, ocular burns etc.
Treatment with preservative-free eye drops will usually be initiated by an ophthalmologist.

11-08-01 Tear deficiency, ocular lubricants, and astringents

Hypromellose

First Choice

0.3% eye drops
0.3% preservative-free eye drops:
- 1st line Tear-Lac®;
- 2nd line PF Drops®
  - treatment to be initiated on the advice of ophthalmologist only

Artificial Tears Minims

Formulary

Hydroxyethylcellulose Artifical Tears Minims 4.4mg per mL Minims Eye Drops

Xailin Night

Formulary

White soft paraffin and mineral oil

Acetylcysteine 5% eye drops and preservative free eye drops

Formulary

Acetylcysteine 5% with Hypromellose 0.35% Ilube

Formulary

Eye drops: acetylcysteine 5%, hypromellose 0.35% (Ilube^®)

Balanced Salt Solution

Formulary

Sterile solution containing sodium chloride 0.64%, sodium acetate 0.39%, sodium citrate 0.17%, calcium chloride 0.048%, magnesium chloride 0.03%, potassium chloride 0.075% in 15ml bottles and 500ml bags.
For intra-ocular or topical irrigation during surgical procedures.

Carbomer 980 eye drops

Formulary

Viscotears® eye drops
GelTears® single unit dose eye drops

Carmellose sodium

Formulary

0.5% and 1% eye drops.

Duolube^® eye ointment

Formulary

UNDER REVIEW

Please note
The brand name will soon change to Sooth Night-time and Duolube will be unable to be ordered

Hylo Night^®

Formulary

Eye ointment (containing retinol palmitate (vitamin A) 250iu/g, white soft paraffin, light liquid paraffin, liquid paraffin and wool fat)

Sodium Chloride

Formulary

0.9% eye drops and single dose unit eye drops.
5% eye drops and preservative-free eye drops.
5% eye ointment unlicensed.

Sodium Hyaluronate

Formulary

0.1% eye drops & preservative-free eye drops
0.2% eye drops & preservative-free eye drops
0.4% unit dose vials (Clinitas) & 0.4% preservative-free eye drops (Clinitas Multi)

Systane^®

Formulary

10ml multidose bottles 0.8ml preservative-free vials Contains hydroxypropyl guar, polyethylene glycol 400, propylene glycol (and other ingredients).
Long-acting ocular lubricant used for the treatment of dry eye syndrome. Liquid formulation which turns into a gel on contact with eyes providing fast and long lasting relief. The multidose bottle may be used for up to six months after opening in primary care. In contact lens wearers, Systane should be applied before inserting lenses and after removal to extend comfortable wearing times.

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